PFT Vision Care Programs

Contact Lenses

Contact lenses – Only if medically required as verified by the PFT Health and Welfare Fund Doctor – up to $80.00 a lens (contact Health & Welfare Office)

Contact lenses that are not medically required will receive an allowance of $73.00 (including the examination)

Note: Members who have Keystone medical coverage have a Vision-Rider benefit administered by Davis Vision. To find a Davis Vision provider, click here. You will need to create an account if don’t have one.

Benefit Periods

Examination – Every calendar year

Lenses and frames or contacts once every two calendar years unless a lens change of .5 diopters is required

Exclusions & Limitations

Expenses for which benefits are payable under any Workers’ Compensation Law

Special procedures such as surgical or medical treatment of the eyes, orthoptics, and visual training

Expenses for services and supplies for which no payment is required of the member

Expenses for services and supplies unless they are prescribed by a legally qualified ophthalmologist, physician, optometrist, or optician

In the event a member, spouse or an eligible dependent is entitled to receive payment from any other source, then in such event the liability of this Fund is limited solely and completely to the payment of the excess, if any, of the amount otherwise payable by this Fund. (Submit to other Program first – then send copy of their form showing payment with the PFT Vision Care form.)

Basic Program

Basic Program Reimbursement

– You are reimbursed after payment

Examination – Every calendar year – up to $25.00 an examination

Lenses – Once every two calendar years unless a change is required in the calendar year as a result of the above examination.

regular lenses (two)……Up to $24.00

bifocal lenses (two)……Up to $38.00

trifocal lenses (two)……Up to $56.00

Frames – Once every two calendar years unless a change is required in the next calendar year as a result of the above lens change…Up to $24.00

How does an eligible person obtain Basic Vision Benefits?

Complete your portion of the form – have the ophthalmologist, optometrist or optician complete the appropriate portions of the form.

Send completed form to the PFT Health and Welfare Office.

You will be reimbursed directly.

If you are not eligible, you will not receive any reimbursement.

N.V.A. Vision Program

Purpose

To provide thorough vision analysis (including Tonometry test), lenses, and a selection of frames with no outlay of money by the member, depending on the type of lenses and frames you chose.

To control the cost of more expensive frames and cosmetic items such as tints and photograys so that the member may save money. The savings could be as much as 50% of the retail cost, again, depending on the choices you make.

If you elect to use one of the participating
optometrist or ophthalmologists there is no out-ofpocket
payment for:

Examination

Fitting fee for frames

Any frames whose wholesale cost is $24.00 or less

Regular size lenses (single or multifocal)

Frames

Your $24.00 allowance is applied to the wholesale cost of the frames. These typically sell at retail prices that range from $48.00 to $72.00.

If you pick more expensive frames, you pay the difference between the $24.00 and the actual wholesale cost, plus 20% of this difference.

ALL CHARGES ARE MONITORED BY N.V.A.

Using an Unlisted Doctor

You may use an unlisted Doctor (use basic form) and use a listed provider. However, check your list of providers carefully in order to see which ones will fit and make glasses without an examination.

Extras

You pay wholesale cost. N.V.A. monitors charges.

Payments

Your basics, as listed above, are covered by the fund. You pay the optometrist or ophthalmologist for the extras.